【摘要】 目的探讨血小板变化与脓毒症患者预后的相关性,为脓毒症的治疗提供新的思路和方法。方法选择2016年12月至2019年6月期间我院诊治的1733例脓毒症患者,依据血小板水平,分为血小板减少组(612例)和血小板正常组(1121例)。比较两组患者,分析血小板与血常规指标的相关性,计算两组患者的累积风险曲线和生存曲线。结果研究发现血小板减少组败血症、休克、机械通气及死亡患者例数占整组病人总数百分比均明显高于正常组,ICU住院日、人均机械通气时间明显高于血小板正常组,且差异有统计学意义(P<0.05);住院第1日和第9日,血小板计数与白细胞、中性粒细胞、抗凝血酶呈正相关,与超敏C反应蛋白呈现负相关(P<0.05)。血小板减少组累积风险更高,生存率更低,并且随着ICU住院时间(ICUSTAY)的延长,累积风险越来越高,生存率越来越低。结论研究表明血小板减少可能导致患者休克、住ICU和机械通气时间延长,血小板减少组患者累积风险更高、生存率更低、危险因素更多。更多还原

【Abstract】 Objective To explore the relationship between platelets and sepsis death,and to provide new ideas and methods for the treatment of sepsis.Methods 1733 patients with sepsis were divided into thrombocytopenia group(612 cases) and normal platelet group(1121 cases) according to platelet levels.The general conditions and laboratory indicators of the two groups were compared.Pearson correlation analysis was used to analyze the correlation between platelet and blood routine indexes.Kaplan Meier was used to draw the cumulative risk curve and survival curve of the two groups.Results The study found that the percentage of septicemia patients,shock patients,mechanical ventilation patients and death cases in thrombocytopenia group was significantly higher than that of normal platelet group,ICU hospitalization days and per capita mechanical ventilation time were significantly higher than those of normal platelet group,and the difference was statistically significant(P<0.05);Correlation analysis showed that platelet count was positively correlated with leukocyte,neutrophil and antithrombin on the first and ninth day of hospitalization,and negatively correlated with high-sensitivity C-reactive protein(P<0.05).Kaplan M eier analysis found that compared with the normal platelet group,the thrombocytopenia group had higher cumulative risk and lower survival rate,and with the extension of ICU stay(ICU stay),the cumulative risk was higher and the survival rate was lower and lower.Conclusion This studie have shown that thrombocytopenia leads to shock,prolonged ICU stays and mechanical ventilation,increasing patients’ cumulative risk,decreasing survival,and increasing patient risk factors.更多还原